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The Efficacy of MDMA (3,4-Methylenedioxymethamphetamine) for Post-traumatic Stress Disorder in Humans: A Systematic Review and Meta-Analysis

Background: 3,4-methylenedioxymethamphetamine (MDMA), known recreationally as “Molly” or “Ecstasy”, is a triple monoamine reuptake inhibitor. MDMA specifically acts as a weak 5-HT1 and 5-HT2 receptor agonist, targeting 5-HT(2A), 5-HT(2B), and 5-HT(2C )receptors. Its potential use for therapeutic pur...

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Autores principales: Tedesco, Sarah, Gajaram, Ganeya, Chida, Shahzad, Ahmad, Arham, Pentak, Meghan, Kelada, Marina, Lewis, Layth, Krishnan, Deepa, Tran, Carolyn, Soetan, Oladipo T, Mukona, Lawrance T, Jolayemi, Ayodeji
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8207489/
https://www.ncbi.nlm.nih.gov/pubmed/34150406
http://dx.doi.org/10.7759/cureus.15070
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author Tedesco, Sarah
Gajaram, Ganeya
Chida, Shahzad
Ahmad, Arham
Pentak, Meghan
Kelada, Marina
Lewis, Layth
Krishnan, Deepa
Tran, Carolyn
Soetan, Oladipo T
Mukona, Lawrance T
Jolayemi, Ayodeji
author_facet Tedesco, Sarah
Gajaram, Ganeya
Chida, Shahzad
Ahmad, Arham
Pentak, Meghan
Kelada, Marina
Lewis, Layth
Krishnan, Deepa
Tran, Carolyn
Soetan, Oladipo T
Mukona, Lawrance T
Jolayemi, Ayodeji
author_sort Tedesco, Sarah
collection PubMed
description Background: 3,4-methylenedioxymethamphetamine (MDMA), known recreationally as “Molly” or “Ecstasy”, is a triple monoamine reuptake inhibitor. MDMA specifically acts as a weak 5-HT1 and 5-HT2 receptor agonist, targeting 5-HT(2A), 5-HT(2B), and 5-HT(2C )receptors. Its potential use for therapeutic purposes with these pharmacological profiles remains a controversial subject. Studies have shown the potential benefits in clinical trials for post-traumatic stress disorder (PTSD). A larger amount of data has been provided for the push in support of MDMA-assisted psychotherapy in these patients.  Objective: The aim of this article is to compute a meta-analysis and conduct a systematic review of the effects of MDMA on PTSD, discussing the potential benefits and adverse events relative to dosing and stability of treatment. Methods: Articles were collected and analyzed for systematic review: 16 articles were included in the systematic review that met the criteria for the use of MDMA in the treatment of PTSD as well as assessing the safety and efficacy of the drug in human participants. Ten studies were used for the meta-analysis, with a cumulative sample size of 168 patients. The significance of the findings on dosing and efficacy of MDMA in healthy human participants was quantified based on the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) and PTSD symptom scores. Results: The disorders for which MDMA demonstrated a net positive or net negative effect on symptoms are presented separately. Adverse events in patients across all disease classes are presented. The therapeutic index for patients who demonstrated a benefit is also presented. An odds ratio for beneficial and adverse events is used to determine treatment-resistant patients who may benefit from clinical trials of MDMA. Discussion: Findings show promising evidence for the potential therapeutic use of MDMA alongside psychotherapy in the treatment of PTSD. The pharmacological profile of MDMA may provide direction for future drug developments to treat patients with treatment-resistant psychiatric disorders.
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spelling pubmed-82074892021-06-17 The Efficacy of MDMA (3,4-Methylenedioxymethamphetamine) for Post-traumatic Stress Disorder in Humans: A Systematic Review and Meta-Analysis Tedesco, Sarah Gajaram, Ganeya Chida, Shahzad Ahmad, Arham Pentak, Meghan Kelada, Marina Lewis, Layth Krishnan, Deepa Tran, Carolyn Soetan, Oladipo T Mukona, Lawrance T Jolayemi, Ayodeji Cureus Neurology Background: 3,4-methylenedioxymethamphetamine (MDMA), known recreationally as “Molly” or “Ecstasy”, is a triple monoamine reuptake inhibitor. MDMA specifically acts as a weak 5-HT1 and 5-HT2 receptor agonist, targeting 5-HT(2A), 5-HT(2B), and 5-HT(2C )receptors. Its potential use for therapeutic purposes with these pharmacological profiles remains a controversial subject. Studies have shown the potential benefits in clinical trials for post-traumatic stress disorder (PTSD). A larger amount of data has been provided for the push in support of MDMA-assisted psychotherapy in these patients.  Objective: The aim of this article is to compute a meta-analysis and conduct a systematic review of the effects of MDMA on PTSD, discussing the potential benefits and adverse events relative to dosing and stability of treatment. Methods: Articles were collected and analyzed for systematic review: 16 articles were included in the systematic review that met the criteria for the use of MDMA in the treatment of PTSD as well as assessing the safety and efficacy of the drug in human participants. Ten studies were used for the meta-analysis, with a cumulative sample size of 168 patients. The significance of the findings on dosing and efficacy of MDMA in healthy human participants was quantified based on the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) and PTSD symptom scores. Results: The disorders for which MDMA demonstrated a net positive or net negative effect on symptoms are presented separately. Adverse events in patients across all disease classes are presented. The therapeutic index for patients who demonstrated a benefit is also presented. An odds ratio for beneficial and adverse events is used to determine treatment-resistant patients who may benefit from clinical trials of MDMA. Discussion: Findings show promising evidence for the potential therapeutic use of MDMA alongside psychotherapy in the treatment of PTSD. The pharmacological profile of MDMA may provide direction for future drug developments to treat patients with treatment-resistant psychiatric disorders. Cureus 2021-05-17 /pmc/articles/PMC8207489/ /pubmed/34150406 http://dx.doi.org/10.7759/cureus.15070 Text en Copyright © 2021, Tedesco et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Neurology
Tedesco, Sarah
Gajaram, Ganeya
Chida, Shahzad
Ahmad, Arham
Pentak, Meghan
Kelada, Marina
Lewis, Layth
Krishnan, Deepa
Tran, Carolyn
Soetan, Oladipo T
Mukona, Lawrance T
Jolayemi, Ayodeji
The Efficacy of MDMA (3,4-Methylenedioxymethamphetamine) for Post-traumatic Stress Disorder in Humans: A Systematic Review and Meta-Analysis
title The Efficacy of MDMA (3,4-Methylenedioxymethamphetamine) for Post-traumatic Stress Disorder in Humans: A Systematic Review and Meta-Analysis
title_full The Efficacy of MDMA (3,4-Methylenedioxymethamphetamine) for Post-traumatic Stress Disorder in Humans: A Systematic Review and Meta-Analysis
title_fullStr The Efficacy of MDMA (3,4-Methylenedioxymethamphetamine) for Post-traumatic Stress Disorder in Humans: A Systematic Review and Meta-Analysis
title_full_unstemmed The Efficacy of MDMA (3,4-Methylenedioxymethamphetamine) for Post-traumatic Stress Disorder in Humans: A Systematic Review and Meta-Analysis
title_short The Efficacy of MDMA (3,4-Methylenedioxymethamphetamine) for Post-traumatic Stress Disorder in Humans: A Systematic Review and Meta-Analysis
title_sort efficacy of mdma (3,4-methylenedioxymethamphetamine) for post-traumatic stress disorder in humans: a systematic review and meta-analysis
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8207489/
https://www.ncbi.nlm.nih.gov/pubmed/34150406
http://dx.doi.org/10.7759/cureus.15070
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